CA2220954A1 - Suture passing forceps - Google Patents
Suture passing forceps Download PDFInfo
- Publication number
- CA2220954A1 CA2220954A1 CA002220954A CA2220954A CA2220954A1 CA 2220954 A1 CA2220954 A1 CA 2220954A1 CA 002220954 A CA002220954 A CA 002220954A CA 2220954 A CA2220954 A CA 2220954A CA 2220954 A1 CA2220954 A1 CA 2220954A1
- Authority
- CA
- Canada
- Prior art keywords
- suture
- needled
- holder
- needle
- thread
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
- 210000001519 tissue Anatomy 0.000 claims description 37
- 238000000034 method Methods 0.000 claims description 18
- 238000004080 punching Methods 0.000 claims description 9
- 238000004873 anchoring Methods 0.000 claims description 3
- 210000000988 bone and bone Anatomy 0.000 claims description 3
- 210000003811 finger Anatomy 0.000 description 3
- 244000228957 Ferula foetida Species 0.000 description 2
- 230000000717 retained effect Effects 0.000 description 2
- 238000007792 addition Methods 0.000 description 1
- 238000002788 crimping Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 210000003813 thumb Anatomy 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/062—Needle manipulators
- A61B17/0625—Needle manipulators the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0485—Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
- A61B2017/0454—Means for attaching and blocking the suture in the suture anchor the anchor being crimped or clamped on the suture
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
- A61B2017/0458—Longitudinal through hole, e.g. suture blocked by a distal suture knot
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
- A61B2017/0488—Instruments for applying suture clamps, clips or locks
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
Abstract
A suture passing forceps includes an axially elongated support shaft (20), and a first suture holder (14) for removably holding a needled suture (30) and a second suture holder (16) for capturing the needled suture. The first suture holder includes a suture inlet (40) through which at least part of the suture can be passed. The first suture holder or the second suture holder is an actuatable member which pivots toward an operating position to capture the needled suture in the second suture holder and pivots away from the operating position to remove the suture from the first suture holder. The suture inlet in the suture holder enables complete removal of the suture from the suture holder when the actuatable member and the needled suture move away from the operating position. The second suture holder includes a holding region defined by a contoured surface permitting the needled suture to slide within the holding region.
Description
CA 022209~4 1997-12-02 W O 96~9948 PCTrUS9 SlrrURE PASSING FORCEPS
Background of the Invention The invention relates generally to suture forceps, 5 and more particularly, to a method and apparatus for passing needled sutures.
Current suturing instruments can include upper and lower jaws with a needle associated with the lower jaw.
The jaws are used to punch the needle through the tissue 10 to be sutured and a suture thread is then fed through the needle, passing the suture thread from the lower jaw to the upper jaw. Other suturing instruments have been known in which a needle is pushed out of a lower jaw and through tissue, passed to an upper jaw, and held in place 15 in the upper jaw with a spring.
Summary of the Invention The invention relates to a suture passing forceps.
The invention features an axially elongated support shaft, and a suturing assembly at a distal end of the 20 support shaft. The suturing assembly includes a first suture holder supported by the support shaft for removably holding a needled suture, and a second suture holder supported by the support shaft for passively capturing the needled suture. The suture holder includes 25 a suture inlet through which at least part of the suture can be passed. The first suture holder or the second suture holder is an actuatable member which pivots toward an operating position to passively capture the needled suture in the second suture holder and pivots away from 30 the operating position to remove the suture from the first suture holder. The suture inlet in the suture holder enables complete and free removal of the suture from the suture holder when the actuatable member and the needled suture move away from the operating position.
CA 022209~4 1997-12-02 W O 96~9948 PCTAUS~C~08~C
In particular emhoA; -nts of the invention, the ~eco~A ~uLu~ e holder is the actuatable member. The first ~uLule holder includes a holding region for removably holding a needle of the needled suture. The first ~uLuLe 5 holder includes a jaw and the ~uLu.e inlet is defined by a slot of a selected width in the jaw through which a ~uLule thread of the needled suture can pass, the holding region being defined by an enlarged section of the slot into which the needle of the needled suture can be 10 placed. The holding region is oriented at an angle of about 90 degrees to an axis of the support shaft and the enlarged section of the slot is oriented to hold the needle at an outward angle of about 5 to 10 degrees to an axis normal to a longitll~i n~ 1 axis of the shaft to better 15 engage the tissue to be ~uL~.ed.
In the illustrated emhoAiment, the second suture holder includes a holding region having a spring force for removably holding a needle of the needled suture. In accordance with the invention, the second holding region 20 defines a passive spring fit. The ~c~nA suture holder includes a jaw having a slot of a selected width, the holding region being defined by an enlarged section of the slot and into which at least a portion of the needle can be spring fit, the relative sizes of the needle and 25 the enlarged section of the second holding region defining, in part, the spring force.
The suture passing forceps include a handle at a proximal end of the ::ju~OL L shaft, the handle being actuatable to move the actuatable member toward and away 30 from its operating position.
In one illustrated embodiment, the second suture holder includes a window enabling a user to confirm that the suture has been passed from the first suture holder to the second suture holder.
CA 022209~4 1997-12-02 W O 96/39948 PCTrUS96/08896 In another illustrated embodiment, the first and ~on~ suture holders include inner surfaces that aid in preventing tissue hang-up thereon.
In accordance with the invention, a needled ~uLu~ e ~ 5 includes a ~uLur e thread and a sharp-tipped n~l e attached to a least one end of the ~uLule thread. The needle includes a substantially straight body co-axially aligned with the suture thread. The body includes a holding portion having a different cross-sectional 10 profile than portions of the body ~l.o- ~n~; ng the holding portion. The body is substantially tubular-~Ap~. The needled has a length of less than about 0.5 inches.
According to another aspect of the invention, a suture anchor assembly includes an Anch~ for attachment 15 to bone; at least one needled ~uLu e for use with the anchor, the needled suture including a ~uLu. e thread and a substantially straight, sharp-tipped needle attached to a least one end of the ~u~u. e thread. The ~le includes a holding portion having a different cross-20 sectional profile than portions of the needle ~u~ dingthe holding portion. The ~uLu~e thread may have a needle attached at each end.
A method of suturing, in accordance with the invention, includes the steps of punching a distal end of 25 a needle of a needled ~uLù~ e through tissue to be ~uLu~ed at a suture site thus creating a hole through the tissue through which a suture thread of the needled ~uLure can pass; grabbing the distal end of the needle in a passive spring fit; moving the actuatable member away from the 30 tissue being ~L~ed to pull the suture thread through the suture hole without engaging a distal end of the suture thread; and removing only a needled end of the needled suture from the suture site by withdrawing the actuating member.
CA 022209~4 1997-12-02 W O 96/39948 PCTAJS9~i'~~96 In accordance with the method of the invention, the plln~hing is facilitated by actuation of the actuatable member pivoting toward its operating position.
The needle is held in a suture holder during plln~hing of 5 the distal end of the needle through the tissue, the method including r ~ ving the needle from the ;,uLure holder by the action of grabbing the distal end of the needle with the actuatable member.
A method of minimally-invasively suturing deep 10 tissue through a portal includes anchoring a ~uLure thread having a needle attached thereto at each end to a suture anchor, suturing a first tissue using a first of the needled ends of the ~uLùre thread, and suturing a c~cQn~ tissue using a second of the needled ends of the 15 YuLule thread, the ~uLuLe thread, during both suturing steps, always being anchored to the ~uLure anchor.
According to another aspect of the invention, a ~uLu~e passing fo~e~a includes an AY; Al ly elongated Yu~or L shaft, and a suturing assembly at a distal end of 20 the support shaft. The suturing assembly includes a first - uLuLe holder supported by the support shaft for removably holding a needled ~uLuLe, and a second suture holder Yu~o~Led by the support shaft for capturing the needled ~uLu~e. The Y~Lu~e holder includes a suture 25 inlet through which at least part of the suture can be p~cs~. The first Y~LU e holder or the second suture holder is an actuatable h~r which pivots toward an operating position to capture the needled suture in the second suture holder and pivots away from the operating 30 position to remove the suture from the first suture holder. The second suture holder includes a holding region partially defined by a contoured surface permitting the needled suture to slide within the holding region.
CA 022209~4 1997-12-02 W O 96/39948 PCTrUS96/08896 In particular ho~i ments of this aspect of the invention, the second suture holder is the actuatable member. The contoured surface is configured to facilitate removal of the needled ~uLu~e from the holding 5 region. The first ~uLu~ e holder includes a jaw and the ~uLuLe inlet is defined by a slot of a selected width in the jaw through which a ~uLu-e thread of the nee~led ~uLu.e can pass. A needle holding region is defined by an enlarged section of the slot and a first portion of 10 the enlarged section has a diameter greater than a diameter of the needle of the ~ee~led suture and a second portion of the enlarged section has a diameter less than the diameter of the ~e~le, The slot is of limited depth ex~en~ing from a surface of the jaw to the enlarged 15 section.
According to another aspect of the invention, a method of suturing includes the steps of p--nCh i ng a distal end of a needle of a needled suture through tissue to be sutured at a ~uLule site thus creating a hole 20 through the ~;cfi~le through which a suture thread of the needled suture can pass; grabbing the distal end of the needle within a holding region in a first ~uLu~e holder;
pulling the ~uLu~e through the suture hole without engaging a distal end of the ~uLu~e thread; .. ving only 25 a needled end of the needled suture from the ~uLule site;
and removing the needled suture from the first ~uLu~e holder by sliding the needled suture along a contoured surface of the holding region.
In accordance with this aspect of the invention, 30 the punching is facilitated by actuation of the suture holder pivoting toward its operating position. The needle is held in a second suture holder during punching of the distal end of the needle through the tissue and the method includes removing the needle from the second 35 suture holder by the action of grabbing the distal end of CA 022209~4 1997-12-02 W O 96/39948 PCTrUS96/08896 the needle with the first ~uL~le holder and moving the first suture holder away from the tis~ue. The distal end of the needle is grabbed in a passive spring fit within the holding region.
Brief Description of the Drawings Other objects, features and advantages of the invention will be apparent from the following description taken together with the drawings in which:
Fig. 1 shows the ~u~e passing fo~ of the 10 invention with a needled ~u~e;
Fig. 2 is a partially cut-away perspective view of the suturing assembly of the ~u~re passing forceps of Fig. 1 shown in an open position;
Fig. 2A is a perspective view of the suturing 15 assembly of Fig. 1 shown in a closed position;
Fig. 3 shows a needled ~uL~e for use with the ~uLuLe passing forceps of Fig. 1;
Fig. 4 shows the suturing assembly of Fig. 2 with the needled ~u~ule of Fig. 3;
Fig. 4A shows the suturing assembly of Fig. 4 in a first operating position;
Fig. 4B shows the suturing A~s~hly of Fig. 4 in a second operating position;
Fig. 4C shows the suturing assembly of Fig. 4 25 after the needled suture has been pas ed through tissue;
Fig. 5 shows an alternative embodiment of the suturing assembly of the suture passing forceps of the invention;
Fig. 6 shows another alternative embodiment of the 30 suturing assembly of the suture passing forceps of the invention;
Fig. 7 shows an anchoring suture for use with the suture passing forceps of the invention;
CA 022209~4 1997-12-02 W O 96/39948 PCTAUS9G~'~3~36 Fig. 8 shows another alternative emho~iment of the suturing assembly of the ~uL~e passing forceps of the invention;
Fig. 8A shows the suturing assembly of Fig. 8 in a 5 first operative position;
Fig. 8B shows the suturing assembly of Fig. 8 in a second operative position; and Fig. 8C is an end view of a suture holder of Fig.
8B, taken along lines 8C-8C.
Description of the Preferred Embodiments Referring to Fig. 1, according to the invention, a ~uLu~e passing forceps 10 for use, e.g., in arthroscopic and endoscopic procedures, includes a suturing assembly 12 having a suture holder 14 for removably holding a 15 needled ~uLu~e 30, and an actuatable member 16.
Actuatable member 16 is pivotably supported by a support shaft 20. A hAn~le 18 ~o~n~cted to ~U~L L shaft 20 is used to actuate actuatable member 16. Handle 18 includes a stationary thumb section 22 and a movable finger 20 section 24. Movement of finger section 24 in the direction of an arrow 26 moves actuatable h~t- 16 in the direction of an arrow 28 to an operating position adjacent the suture holder 14 (Fig. 2a). The reverse motion of finger section 24 returns actuatable member 16 25 to its original position. An actuation ?chAn;l such as used in the Smith & Nephew Dyonics 2.7 mm. Scoop, product ~7204665, may be used. Suture passing forceps 10 include a suture tie off post 31, for example, a pin with an o-ring placed between a head of the pin and body 33 of 30 forceps 10. While the illustrated embo~; ?nt shows suture holder 14 as stationary and actuatable -T~h~ 16 pivotably mounted, suture holder 14 can be pivotably mounted and actuatable h~t- 16 stationary.
Referring to Figs. 2 and 2A, suture holder 14 35 includes a jaw 39 with a suture inlet slot 40 and a CA 022209~4 1997-12-02 W O 96/39948 PCTfUS~G~C89.~6 needle holding region 42 for removably holding a needle of needled ~u~u~ e 30. Needle holding region 42 is defined by an enlarged area of slot 40 which extends from a distal end 42a of jaw 39 to a ledge 42b. Slot 40 cuts 5 through the entire region of jaw 39. ~aw 39 is oriented so that its axis 17 is about 90 degrees to a longi~ ; nA
axis 15 of ~u~or~ shaft 20. Holding region 42 is oriented to hold a needle of needled ~L~e 30 at an angle ~ of about 5 to 10 degrees from axis 17 of jaw 39 10 to better enable a needle to engage the tissue to be ~uLuL~d. As will be described in more detail below, slot 40 enables complete removal of needled suture 30 from suture holder 14 after passage of the needled suture through tissue. Actuatable h~t- 16 includes a jaw 43 15 with a slot 44 having enlarged section 4S with a needle holding region 46 of smaller width than enlarged section 45. A ledge 46a in enlarged section 45 defines needle holding region 46.
A xuLule needle can be removably held within 20 xu~u. e holding region 42 of jaw 39. Slot 40 has a width of, e.g., about 0.021"; holding region 42 has a diameter of, e.g., about 0.034 - 0.035"; and needle 50 (see Fig.
3) has a diameter of, e.g., about 0.0315" - 0.0335".
Needle 50 rests against ledge 42b of holding region 42 25 and suture thread 52 (see Fig. 4) passes through slot 40 and is tied off on post 31. Alternatively, holding region 42 can sized to produce a spring fit with needle 50. Needle 50 can be held within holding region 46 of jaw 43 by the force of a passive spring fit. The 30 relative sizes of the diameter or size of holding region 46 and the diameter of needle 50 in combination with the spring constant associated with the material of the jaw 43 define the spring force with which needle 50 is held within holding region 46. Slot 44 has a width of, e.g., 35 about 0.01"; holding region 46 has a width of, e.g., CA 022209~4 1997-12-02 W O 96/39948 PCTrUS9G~ 36 about 0.021" - 0.026" and a length of, e.g., about 0.06";
and a crimped area of the ne~le 50, described further - below, has a width of, e.g., about 0.025" - 0.027". The holding force of actuatable h~- 16 on the needle is ~ 5 greater than the holding force of ~uLu. e holder 14 on the needle. This difference in holding force enables the needle to be pA~ from ~uLule holder 14 to actuatable h~~ 16, as described below.
Referring to Fig. 3, needled ~uL~re 30 for use 10 with YuLule passing fo~ce~ 10 includes a needle 50 co-axially aligned with ~uLu e thread 52 and attached, e.g., by crimping or clamping, to suture thread 52 at an attachment area 51. Needle 50 includes a substantially straight, tubular Ch~r~ body 53 and a pointed distal tip 15 54 for ease of passage through tissue. The length of needle 50 is less than about 0.5" and preferably about 0.3". It is the attachment area 51 that is held by holding region 46 of actuatable member 16. SuLuLe thread 52 may be, e.g., #1 or #2 size ~uLu,es, monofilament or 20 braided.
Referring to Figs. 4-4C, in use needle 50 of needled suture 30 is placed in suture holding region 42 by passing thread 52 through slot 40 and pulling on thread 52 to place needle 50 within holding region 42.
25 Handle 18 is actuated moving actuatable member 16 to the operating position shown in Fig. 4B, as needle 50 is pushed through the tissue 60 to be sutured. Closing of actuatable -mh~ 16 results in distal tip 54 of needle 50 being held within holding region 46 of actuatable 30 member 16 (Fig. 4B). Due to the greater holding force of holding region 46 of actuatable member 16 as compared to the holding force of holding region 42 of suture holder 14, when actuatable member 16 is moved to its open position, needle 50 is passed from suture holder 14 to 35 actuatable member 16 (Fig. 4C). Suture thread 52 is then CA 022209~4 1997-12-02 free to pass through slot 40 to completely remove needled ~uLu~e 30 from ~L~re holder 14. Needle 50 can be pulled free from actuatable member 16 and suture thread 42 can then be cut and tied off.
Among the many advantages of the present suturing t~chn;que are passive capture of the needle within the holding regions, one-step ~uLule passing, one-h~n~
suturing action and complete removal of the needled ~uLu e from the ~uLùr e holder after suture passing.
Referring to Fig. 5, in an alternative and preferred emho~;ment, suturing assembly 112 includes an actuatable member 116 having a window 148 through which needle 50 can be seen. Window 148 enables a user to confirm that the needle has been pAc~A from suture 15 holder 114 to actuatable member 116.
Referring to Fig. 6, in an alternative embodiment, ~uLuLe holder 214 and actuatable member 216 include inner surfaces 215, 217, respectively, that aid in preventing tissue hang-up during removal of the suLu~ e passing 20 forceps after needled suture 30 has been p~ from ~uL~e holder 214 to actuatable member 216, as described above. S~L~e holder 214 includes a jaw 239 with a suture inlet slot 240 and a needle holding region 242 for removably holding a needle. Actuatable member 216 25 includes a jaw 243 with a slot 244 with an enlarged section 245 defining a needle holding region, as ced above.
Referring to Fig. 7, the suture passing forceps of the invention can be used with a suture anchor 80 for 30 attachment to bone 84. A needled suture 82 passes through an opening of anchor 80. Needled suture 82 includes a suture thread 86 and a substantially straight, tubular-shaped, sharp-tipped needle 88, corresponding to needle 50 of Fig. 3, attached to one or both ends of 35 suture thread 86.
. CA 022209~4 1997-12-02 W O 96/39948 PCTAU59~ 36 In use during minimally-invasive suturing of deep tissue through a portal, suture thread 86 with needles 88 is passed through xuLule ~ncho~ 80, and, optionally, tied or crimped to suture anchor 80. A first ~iC~le is 5 sutured using one of the needled ends of ~uLu~e thread 86 and a second tissue is sutured using the other n~e~ed end of ~uLu~e thread 86. During both suturing steps, ~uL~,e thread 86 is always passing through suture An~hn~
80.
Referring to Figs. 8-8C, in an alternative and preferred ~ ho~i -nt, a suturing A!~ hly 312 includes an actuatable member 316 having a window 348 through which needle 50 can be seen. Window 348 enables a user to confirm that the needle has been passed from a ~uLule 15 holder 314 to actuatable member 316. Actuatable ~ h.~l~
316 includes first and second member halves 350, 352 having contoured inner surfaces 354 defining a needle holding region 346, and corresponAing contoured outer surfaces 356 (only the contoured surfaces of member half 20 350 being shown). Needle holding region 346 may be created, for example, using electrical discharge maçh;n;ng using a ram shaped to create contoured inner surfaces 354. Halves 350, 352 define an open slot 344 between them into which needle 50 enters and is retained.
Referring particularly to Figs. 8A and 8B, needle 50 is passed through tissue 60 and initially is retained by actuatable -- he~ 316, as described previously. In this preferred emboA; ent of the invention, the needle is held, in a passive spring fit, between halves 350, 352 at 30 the edges 353a, 353b (Fig. 8) along a relatively flat region 370 of inner surfaces 354. It is the suture thread attachment area 51 of needle 50 which has a smaller diameter than a leading section 355 of the needle that is located between edges 353a, 353b. The actuatable 35 member 316 is opened (moved in the direction of arrow CA 022209~4 1997-12-02 W O 96/39948 PCTAJ59G~
358~, and the entire suturing assembly 312 is pulled away from tissue 60 releasing ~uLule thread 52 from ~uLuLe holder 314 and pulling ~L~Le thread 52 through tissue 60.
During the op~n; ng motion of actuatable 316, needle 50 advantageously slides within ~uLuLe holding region 346 along slot 344 allowing needle 50 to align with the suture thread as the thread tugs on the needle. Contoured inner surfaces 354, and particularly 10 contoured region 372, allow the needle to slide within holding region 346 without creating any undesirable loads between needle 50 and member halves 350, 352 which may tend to pull needle 50 from the suture holding region.
Additionally, contoured region 372 facilitates removal of 15 needle 50 from actuating member 316 by guiding attachment area 51 of needle 50 in the direction of arrow 360.
Needle 50 is guided along inner surfaces 354 of actuating member 316 and exits from the top 345 (Fig. 8) of slot 344 by appropriate manipulation of actuatable member 316 20 and needled suture 30.
It is desirable that the radius of contoured region 372 be as large as possible while still preserving a length of flat region 370 that is long enough, for example about 0.04", to initially capture needle 50.
Referring to Figs. 8A and 8C, suture holder 314 includes an enlarged holding region 342 with a needle holding ledge 342b against which needle 50 rests when positioned in suture holder 314. A s]ot 340 extends from an external surface 314a of ~uLuLe holder 314 to enlarged 30 region 342.
Additions, subtractions and other modifications of the illustrated embodiments of the invention will be apparent to those practiced in the art and are within the scope of the following claims.
Background of the Invention The invention relates generally to suture forceps, 5 and more particularly, to a method and apparatus for passing needled sutures.
Current suturing instruments can include upper and lower jaws with a needle associated with the lower jaw.
The jaws are used to punch the needle through the tissue 10 to be sutured and a suture thread is then fed through the needle, passing the suture thread from the lower jaw to the upper jaw. Other suturing instruments have been known in which a needle is pushed out of a lower jaw and through tissue, passed to an upper jaw, and held in place 15 in the upper jaw with a spring.
Summary of the Invention The invention relates to a suture passing forceps.
The invention features an axially elongated support shaft, and a suturing assembly at a distal end of the 20 support shaft. The suturing assembly includes a first suture holder supported by the support shaft for removably holding a needled suture, and a second suture holder supported by the support shaft for passively capturing the needled suture. The suture holder includes 25 a suture inlet through which at least part of the suture can be passed. The first suture holder or the second suture holder is an actuatable member which pivots toward an operating position to passively capture the needled suture in the second suture holder and pivots away from 30 the operating position to remove the suture from the first suture holder. The suture inlet in the suture holder enables complete and free removal of the suture from the suture holder when the actuatable member and the needled suture move away from the operating position.
CA 022209~4 1997-12-02 W O 96~9948 PCTAUS~C~08~C
In particular emhoA; -nts of the invention, the ~eco~A ~uLu~ e holder is the actuatable member. The first ~uLule holder includes a holding region for removably holding a needle of the needled suture. The first ~uLuLe 5 holder includes a jaw and the ~uLu.e inlet is defined by a slot of a selected width in the jaw through which a ~uLule thread of the needled suture can pass, the holding region being defined by an enlarged section of the slot into which the needle of the needled suture can be 10 placed. The holding region is oriented at an angle of about 90 degrees to an axis of the support shaft and the enlarged section of the slot is oriented to hold the needle at an outward angle of about 5 to 10 degrees to an axis normal to a longitll~i n~ 1 axis of the shaft to better 15 engage the tissue to be ~uL~.ed.
In the illustrated emhoAiment, the second suture holder includes a holding region having a spring force for removably holding a needle of the needled suture. In accordance with the invention, the second holding region 20 defines a passive spring fit. The ~c~nA suture holder includes a jaw having a slot of a selected width, the holding region being defined by an enlarged section of the slot and into which at least a portion of the needle can be spring fit, the relative sizes of the needle and 25 the enlarged section of the second holding region defining, in part, the spring force.
The suture passing forceps include a handle at a proximal end of the ::ju~OL L shaft, the handle being actuatable to move the actuatable member toward and away 30 from its operating position.
In one illustrated embodiment, the second suture holder includes a window enabling a user to confirm that the suture has been passed from the first suture holder to the second suture holder.
CA 022209~4 1997-12-02 W O 96/39948 PCTrUS96/08896 In another illustrated embodiment, the first and ~on~ suture holders include inner surfaces that aid in preventing tissue hang-up thereon.
In accordance with the invention, a needled ~uLu~ e ~ 5 includes a ~uLur e thread and a sharp-tipped n~l e attached to a least one end of the ~uLule thread. The needle includes a substantially straight body co-axially aligned with the suture thread. The body includes a holding portion having a different cross-sectional 10 profile than portions of the body ~l.o- ~n~; ng the holding portion. The body is substantially tubular-~Ap~. The needled has a length of less than about 0.5 inches.
According to another aspect of the invention, a suture anchor assembly includes an Anch~ for attachment 15 to bone; at least one needled ~uLu e for use with the anchor, the needled suture including a ~uLu. e thread and a substantially straight, sharp-tipped needle attached to a least one end of the ~u~u. e thread. The ~le includes a holding portion having a different cross-20 sectional profile than portions of the needle ~u~ dingthe holding portion. The ~uLu~e thread may have a needle attached at each end.
A method of suturing, in accordance with the invention, includes the steps of punching a distal end of 25 a needle of a needled ~uLù~ e through tissue to be ~uLu~ed at a suture site thus creating a hole through the tissue through which a suture thread of the needled ~uLure can pass; grabbing the distal end of the needle in a passive spring fit; moving the actuatable member away from the 30 tissue being ~L~ed to pull the suture thread through the suture hole without engaging a distal end of the suture thread; and removing only a needled end of the needled suture from the suture site by withdrawing the actuating member.
CA 022209~4 1997-12-02 W O 96/39948 PCTAJS9~i'~~96 In accordance with the method of the invention, the plln~hing is facilitated by actuation of the actuatable member pivoting toward its operating position.
The needle is held in a suture holder during plln~hing of 5 the distal end of the needle through the tissue, the method including r ~ ving the needle from the ;,uLure holder by the action of grabbing the distal end of the needle with the actuatable member.
A method of minimally-invasively suturing deep 10 tissue through a portal includes anchoring a ~uLure thread having a needle attached thereto at each end to a suture anchor, suturing a first tissue using a first of the needled ends of the ~uLùre thread, and suturing a c~cQn~ tissue using a second of the needled ends of the 15 YuLule thread, the ~uLuLe thread, during both suturing steps, always being anchored to the ~uLure anchor.
According to another aspect of the invention, a ~uLu~e passing fo~e~a includes an AY; Al ly elongated Yu~or L shaft, and a suturing assembly at a distal end of 20 the support shaft. The suturing assembly includes a first - uLuLe holder supported by the support shaft for removably holding a needled ~uLuLe, and a second suture holder Yu~o~Led by the support shaft for capturing the needled ~uLu~e. The Y~Lu~e holder includes a suture 25 inlet through which at least part of the suture can be p~cs~. The first Y~LU e holder or the second suture holder is an actuatable h~r which pivots toward an operating position to capture the needled suture in the second suture holder and pivots away from the operating 30 position to remove the suture from the first suture holder. The second suture holder includes a holding region partially defined by a contoured surface permitting the needled suture to slide within the holding region.
CA 022209~4 1997-12-02 W O 96/39948 PCTrUS96/08896 In particular ho~i ments of this aspect of the invention, the second suture holder is the actuatable member. The contoured surface is configured to facilitate removal of the needled ~uLu~e from the holding 5 region. The first ~uLu~ e holder includes a jaw and the ~uLuLe inlet is defined by a slot of a selected width in the jaw through which a ~uLu-e thread of the nee~led ~uLu.e can pass. A needle holding region is defined by an enlarged section of the slot and a first portion of 10 the enlarged section has a diameter greater than a diameter of the needle of the ~ee~led suture and a second portion of the enlarged section has a diameter less than the diameter of the ~e~le, The slot is of limited depth ex~en~ing from a surface of the jaw to the enlarged 15 section.
According to another aspect of the invention, a method of suturing includes the steps of p--nCh i ng a distal end of a needle of a needled suture through tissue to be sutured at a ~uLule site thus creating a hole 20 through the ~;cfi~le through which a suture thread of the needled suture can pass; grabbing the distal end of the needle within a holding region in a first ~uLu~e holder;
pulling the ~uLu~e through the suture hole without engaging a distal end of the ~uLu~e thread; .. ving only 25 a needled end of the needled suture from the ~uLule site;
and removing the needled suture from the first ~uLu~e holder by sliding the needled suture along a contoured surface of the holding region.
In accordance with this aspect of the invention, 30 the punching is facilitated by actuation of the suture holder pivoting toward its operating position. The needle is held in a second suture holder during punching of the distal end of the needle through the tissue and the method includes removing the needle from the second 35 suture holder by the action of grabbing the distal end of CA 022209~4 1997-12-02 W O 96/39948 PCTrUS96/08896 the needle with the first ~uL~le holder and moving the first suture holder away from the tis~ue. The distal end of the needle is grabbed in a passive spring fit within the holding region.
Brief Description of the Drawings Other objects, features and advantages of the invention will be apparent from the following description taken together with the drawings in which:
Fig. 1 shows the ~u~e passing fo~ of the 10 invention with a needled ~u~e;
Fig. 2 is a partially cut-away perspective view of the suturing assembly of the ~u~re passing forceps of Fig. 1 shown in an open position;
Fig. 2A is a perspective view of the suturing 15 assembly of Fig. 1 shown in a closed position;
Fig. 3 shows a needled ~uL~e for use with the ~uLuLe passing forceps of Fig. 1;
Fig. 4 shows the suturing assembly of Fig. 2 with the needled ~u~ule of Fig. 3;
Fig. 4A shows the suturing assembly of Fig. 4 in a first operating position;
Fig. 4B shows the suturing A~s~hly of Fig. 4 in a second operating position;
Fig. 4C shows the suturing assembly of Fig. 4 25 after the needled suture has been pas ed through tissue;
Fig. 5 shows an alternative embodiment of the suturing assembly of the suture passing forceps of the invention;
Fig. 6 shows another alternative embodiment of the 30 suturing assembly of the suture passing forceps of the invention;
Fig. 7 shows an anchoring suture for use with the suture passing forceps of the invention;
CA 022209~4 1997-12-02 W O 96/39948 PCTAUS9G~'~3~36 Fig. 8 shows another alternative emho~iment of the suturing assembly of the ~uL~e passing forceps of the invention;
Fig. 8A shows the suturing assembly of Fig. 8 in a 5 first operative position;
Fig. 8B shows the suturing assembly of Fig. 8 in a second operative position; and Fig. 8C is an end view of a suture holder of Fig.
8B, taken along lines 8C-8C.
Description of the Preferred Embodiments Referring to Fig. 1, according to the invention, a ~uLu~e passing forceps 10 for use, e.g., in arthroscopic and endoscopic procedures, includes a suturing assembly 12 having a suture holder 14 for removably holding a 15 needled ~uLu~e 30, and an actuatable member 16.
Actuatable member 16 is pivotably supported by a support shaft 20. A hAn~le 18 ~o~n~cted to ~U~L L shaft 20 is used to actuate actuatable member 16. Handle 18 includes a stationary thumb section 22 and a movable finger 20 section 24. Movement of finger section 24 in the direction of an arrow 26 moves actuatable h~t- 16 in the direction of an arrow 28 to an operating position adjacent the suture holder 14 (Fig. 2a). The reverse motion of finger section 24 returns actuatable member 16 25 to its original position. An actuation ?chAn;l such as used in the Smith & Nephew Dyonics 2.7 mm. Scoop, product ~7204665, may be used. Suture passing forceps 10 include a suture tie off post 31, for example, a pin with an o-ring placed between a head of the pin and body 33 of 30 forceps 10. While the illustrated embo~; ?nt shows suture holder 14 as stationary and actuatable -T~h~ 16 pivotably mounted, suture holder 14 can be pivotably mounted and actuatable h~t- 16 stationary.
Referring to Figs. 2 and 2A, suture holder 14 35 includes a jaw 39 with a suture inlet slot 40 and a CA 022209~4 1997-12-02 W O 96/39948 PCTfUS~G~C89.~6 needle holding region 42 for removably holding a needle of needled ~u~u~ e 30. Needle holding region 42 is defined by an enlarged area of slot 40 which extends from a distal end 42a of jaw 39 to a ledge 42b. Slot 40 cuts 5 through the entire region of jaw 39. ~aw 39 is oriented so that its axis 17 is about 90 degrees to a longi~ ; nA
axis 15 of ~u~or~ shaft 20. Holding region 42 is oriented to hold a needle of needled ~L~e 30 at an angle ~ of about 5 to 10 degrees from axis 17 of jaw 39 10 to better enable a needle to engage the tissue to be ~uLuL~d. As will be described in more detail below, slot 40 enables complete removal of needled suture 30 from suture holder 14 after passage of the needled suture through tissue. Actuatable h~t- 16 includes a jaw 43 15 with a slot 44 having enlarged section 4S with a needle holding region 46 of smaller width than enlarged section 45. A ledge 46a in enlarged section 45 defines needle holding region 46.
A xuLule needle can be removably held within 20 xu~u. e holding region 42 of jaw 39. Slot 40 has a width of, e.g., about 0.021"; holding region 42 has a diameter of, e.g., about 0.034 - 0.035"; and needle 50 (see Fig.
3) has a diameter of, e.g., about 0.0315" - 0.0335".
Needle 50 rests against ledge 42b of holding region 42 25 and suture thread 52 (see Fig. 4) passes through slot 40 and is tied off on post 31. Alternatively, holding region 42 can sized to produce a spring fit with needle 50. Needle 50 can be held within holding region 46 of jaw 43 by the force of a passive spring fit. The 30 relative sizes of the diameter or size of holding region 46 and the diameter of needle 50 in combination with the spring constant associated with the material of the jaw 43 define the spring force with which needle 50 is held within holding region 46. Slot 44 has a width of, e.g., 35 about 0.01"; holding region 46 has a width of, e.g., CA 022209~4 1997-12-02 W O 96/39948 PCTrUS9G~ 36 about 0.021" - 0.026" and a length of, e.g., about 0.06";
and a crimped area of the ne~le 50, described further - below, has a width of, e.g., about 0.025" - 0.027". The holding force of actuatable h~- 16 on the needle is ~ 5 greater than the holding force of ~uLu. e holder 14 on the needle. This difference in holding force enables the needle to be pA~ from ~uLule holder 14 to actuatable h~~ 16, as described below.
Referring to Fig. 3, needled ~uL~re 30 for use 10 with YuLule passing fo~ce~ 10 includes a needle 50 co-axially aligned with ~uLu e thread 52 and attached, e.g., by crimping or clamping, to suture thread 52 at an attachment area 51. Needle 50 includes a substantially straight, tubular Ch~r~ body 53 and a pointed distal tip 15 54 for ease of passage through tissue. The length of needle 50 is less than about 0.5" and preferably about 0.3". It is the attachment area 51 that is held by holding region 46 of actuatable member 16. SuLuLe thread 52 may be, e.g., #1 or #2 size ~uLu,es, monofilament or 20 braided.
Referring to Figs. 4-4C, in use needle 50 of needled suture 30 is placed in suture holding region 42 by passing thread 52 through slot 40 and pulling on thread 52 to place needle 50 within holding region 42.
25 Handle 18 is actuated moving actuatable member 16 to the operating position shown in Fig. 4B, as needle 50 is pushed through the tissue 60 to be sutured. Closing of actuatable -mh~ 16 results in distal tip 54 of needle 50 being held within holding region 46 of actuatable 30 member 16 (Fig. 4B). Due to the greater holding force of holding region 46 of actuatable member 16 as compared to the holding force of holding region 42 of suture holder 14, when actuatable member 16 is moved to its open position, needle 50 is passed from suture holder 14 to 35 actuatable member 16 (Fig. 4C). Suture thread 52 is then CA 022209~4 1997-12-02 free to pass through slot 40 to completely remove needled ~uLu~e 30 from ~L~re holder 14. Needle 50 can be pulled free from actuatable member 16 and suture thread 42 can then be cut and tied off.
Among the many advantages of the present suturing t~chn;que are passive capture of the needle within the holding regions, one-step ~uLule passing, one-h~n~
suturing action and complete removal of the needled ~uLu e from the ~uLùr e holder after suture passing.
Referring to Fig. 5, in an alternative and preferred emho~;ment, suturing assembly 112 includes an actuatable member 116 having a window 148 through which needle 50 can be seen. Window 148 enables a user to confirm that the needle has been pAc~A from suture 15 holder 114 to actuatable member 116.
Referring to Fig. 6, in an alternative embodiment, ~uLuLe holder 214 and actuatable member 216 include inner surfaces 215, 217, respectively, that aid in preventing tissue hang-up during removal of the suLu~ e passing 20 forceps after needled suture 30 has been p~ from ~uL~e holder 214 to actuatable member 216, as described above. S~L~e holder 214 includes a jaw 239 with a suture inlet slot 240 and a needle holding region 242 for removably holding a needle. Actuatable member 216 25 includes a jaw 243 with a slot 244 with an enlarged section 245 defining a needle holding region, as ced above.
Referring to Fig. 7, the suture passing forceps of the invention can be used with a suture anchor 80 for 30 attachment to bone 84. A needled suture 82 passes through an opening of anchor 80. Needled suture 82 includes a suture thread 86 and a substantially straight, tubular-shaped, sharp-tipped needle 88, corresponding to needle 50 of Fig. 3, attached to one or both ends of 35 suture thread 86.
. CA 022209~4 1997-12-02 W O 96/39948 PCTAU59~ 36 In use during minimally-invasive suturing of deep tissue through a portal, suture thread 86 with needles 88 is passed through xuLule ~ncho~ 80, and, optionally, tied or crimped to suture anchor 80. A first ~iC~le is 5 sutured using one of the needled ends of ~uLu~e thread 86 and a second tissue is sutured using the other n~e~ed end of ~uLu~e thread 86. During both suturing steps, ~uL~,e thread 86 is always passing through suture An~hn~
80.
Referring to Figs. 8-8C, in an alternative and preferred ~ ho~i -nt, a suturing A!~ hly 312 includes an actuatable member 316 having a window 348 through which needle 50 can be seen. Window 348 enables a user to confirm that the needle has been passed from a ~uLule 15 holder 314 to actuatable member 316. Actuatable ~ h.~l~
316 includes first and second member halves 350, 352 having contoured inner surfaces 354 defining a needle holding region 346, and corresponAing contoured outer surfaces 356 (only the contoured surfaces of member half 20 350 being shown). Needle holding region 346 may be created, for example, using electrical discharge maçh;n;ng using a ram shaped to create contoured inner surfaces 354. Halves 350, 352 define an open slot 344 between them into which needle 50 enters and is retained.
Referring particularly to Figs. 8A and 8B, needle 50 is passed through tissue 60 and initially is retained by actuatable -- he~ 316, as described previously. In this preferred emboA; ent of the invention, the needle is held, in a passive spring fit, between halves 350, 352 at 30 the edges 353a, 353b (Fig. 8) along a relatively flat region 370 of inner surfaces 354. It is the suture thread attachment area 51 of needle 50 which has a smaller diameter than a leading section 355 of the needle that is located between edges 353a, 353b. The actuatable 35 member 316 is opened (moved in the direction of arrow CA 022209~4 1997-12-02 W O 96/39948 PCTAJ59G~
358~, and the entire suturing assembly 312 is pulled away from tissue 60 releasing ~uLule thread 52 from ~uLuLe holder 314 and pulling ~L~Le thread 52 through tissue 60.
During the op~n; ng motion of actuatable 316, needle 50 advantageously slides within ~uLuLe holding region 346 along slot 344 allowing needle 50 to align with the suture thread as the thread tugs on the needle. Contoured inner surfaces 354, and particularly 10 contoured region 372, allow the needle to slide within holding region 346 without creating any undesirable loads between needle 50 and member halves 350, 352 which may tend to pull needle 50 from the suture holding region.
Additionally, contoured region 372 facilitates removal of 15 needle 50 from actuating member 316 by guiding attachment area 51 of needle 50 in the direction of arrow 360.
Needle 50 is guided along inner surfaces 354 of actuating member 316 and exits from the top 345 (Fig. 8) of slot 344 by appropriate manipulation of actuatable member 316 20 and needled suture 30.
It is desirable that the radius of contoured region 372 be as large as possible while still preserving a length of flat region 370 that is long enough, for example about 0.04", to initially capture needle 50.
Referring to Figs. 8A and 8C, suture holder 314 includes an enlarged holding region 342 with a needle holding ledge 342b against which needle 50 rests when positioned in suture holder 314. A s]ot 340 extends from an external surface 314a of ~uLuLe holder 314 to enlarged 30 region 342.
Additions, subtractions and other modifications of the illustrated embodiments of the invention will be apparent to those practiced in the art and are within the scope of the following claims.
Claims (38)
1. A suture passing forceps, comprising:
an axially elongated support shaft, and a suturing assembly at a distal end of said support shaft, including a first suture holder supported by said support shaft for removably holding a needled suture, said first suture holder including a suture inlet through which at least part of the suture can be passed, and a second suture holder supported by said support shaft for passively capturing said needled suture, said first suture holder or said second suture holder being an actuatable member pivotably supported for movement toward and away from an operating position to passively capture said needled suture in said second suture holder as the actuatable member moves toward the operating position, and to remove the needled suture from said first suture holder when said actuatable member moves away from said operating position, said suture inlet in said first suture holder enabling complete removal of the suture from said first suture holder when said actuatable member and said needled suture move away from said operating position.
an axially elongated support shaft, and a suturing assembly at a distal end of said support shaft, including a first suture holder supported by said support shaft for removably holding a needled suture, said first suture holder including a suture inlet through which at least part of the suture can be passed, and a second suture holder supported by said support shaft for passively capturing said needled suture, said first suture holder or said second suture holder being an actuatable member pivotably supported for movement toward and away from an operating position to passively capture said needled suture in said second suture holder as the actuatable member moves toward the operating position, and to remove the needled suture from said first suture holder when said actuatable member moves away from said operating position, said suture inlet in said first suture holder enabling complete removal of the suture from said first suture holder when said actuatable member and said needled suture move away from said operating position.
2. The suture passing forceps of claim 1 wherein said second suture holder comprises said actuatable member.
3. The suture passing forceps of claim 1 wherein said first suture holder includes a holding region for removably holding a needle of the needled suture.
4. The suture passing forceps of claim 3 wherein said first suture holder includes a jaw and said suture inlet is defined by a slot of a selected width in said jaw through which a suture thread of the needled suture can pass, said holding region being defined by an enlarged section of said slot into which the needle of the needled suture can be placed.
5. The suture passing forceps of claim 4 wherein said holding region is oriented at an angle of about 90 degrees to an axis of said support shaft.
6. The suture passing forceps of claim 4 wherein said enlarged section of said slot is oriented to hold the needle at an outward angle of about 5 to 10 degrees to an axis normal to a longitudinal axis of the support shaft.
7. The suture passing forceps of claim 1 wherein said second suture holder includes a holding region having a spring force for removably holding a needle of the needled suture.
8. The suture passing forceps of claim 7 wherein said holding region defines a passive spring fit.
9. The suture passing forceps of claim 7 wherein said second suture holder includes a jaw defining a slot of a selected width, said holding region being defined by an enlarged section of said slot into which at least a portion of the needle can be spring fit, the relative sizes of said needle and said enlarged section of said holding region defining, in part, said spring force.
10. The suture passing forceps of claim 1 further including a handle at a proximal end of said support shaft, said handle being actuatable to move said actuatable member toward and away from its operating position.
11. The suture passing forceps of claim 1 wherein said second suture holder further comprises a window enabling a user to confirm that the suture has been passed from said first suture holder to said second suture holder.
12. The suture passing forceps of claim 1 wherein said first and second suture holders include inner surfaces that aid in preventing tissue hang-up thereon.
13. A suture passing forceps, comprising:
an axially elongated support shaft, and a suturing assembly at a distal end of said support shaft, including a suture holder supported by said support shaft and including a jaw and a suture inlet defined by a slot of a selected width in said jaw through which a suture thread of the needled suture can pass, and a holding region defined by an enlarged section of said slot for removably holding a needle of a needled suture, and an actuatable member pivotably supported for movement toward and away from an operating position to passively capture said needled suture as the actuatable member moves toward the operating position, and to remove the needled suture from said suture holder when said actuatable member moves away from said operating position, said suture inlet in said suture holder enabling complete removal of the suture from said suture holder when said actuatable member and said needled suture move away from said operating position, said actuatable member including a jaw defining a slot of a selected width, a second holding region being defined by an enlarged section of said slot into which at least a portion of the needle can be spring fit, the relative sizes of said needle and said enlarged section of said holding region defining, in part, a spring force.
an axially elongated support shaft, and a suturing assembly at a distal end of said support shaft, including a suture holder supported by said support shaft and including a jaw and a suture inlet defined by a slot of a selected width in said jaw through which a suture thread of the needled suture can pass, and a holding region defined by an enlarged section of said slot for removably holding a needle of a needled suture, and an actuatable member pivotably supported for movement toward and away from an operating position to passively capture said needled suture as the actuatable member moves toward the operating position, and to remove the needled suture from said suture holder when said actuatable member moves away from said operating position, said suture inlet in said suture holder enabling complete removal of the suture from said suture holder when said actuatable member and said needled suture move away from said operating position, said actuatable member including a jaw defining a slot of a selected width, a second holding region being defined by an enlarged section of said slot into which at least a portion of the needle can be spring fit, the relative sizes of said needle and said enlarged section of said holding region defining, in part, a spring force.
14. A needled suture, comprising:
a suture thread, and a sharp-tipped needle attached to a least one end of said suture thread, said needle having a substantially straight body co-axially aligned with said suture thread, said body including a holding portion having a different cross-sectional profile than portions of said body surrounding said holding portion.
a suture thread, and a sharp-tipped needle attached to a least one end of said suture thread, said needle having a substantially straight body co-axially aligned with said suture thread, said body including a holding portion having a different cross-sectional profile than portions of said body surrounding said holding portion.
15. The needled suture of claim 14 wherein said body is substantially tubular-shaped.
16. The needled suture of claim 14 wherein said needle has a length of less than about 0.5 inches.
17. A suture passing forceps for passing a needled suture, comprising:
an axially elongated support shaft, and a suturing assembly at a distal end of said support shaft, including a first suture holder supported by said support shaft for removably holding a needled suture, said first suture holder including a suture inlet through which at least part of the suture can be passed, and a second suture holder supported by said support shaft for passively capturing said needled suture, said first suture holder or said second suture holder being an actuatable member pivotably supported for movement toward and away from an operating position to passively capture said needled suture in said second suture holder as the actuatable member moves toward the operating position, and to remove the needled suture from said first suture holder when said actuatable member moves away from said operating position, said suture inlet in said first suture holder enabling complete removal of the suture from said first suture holder when said actuatable member and said needled suture move away from said operating position, said needled suture comprising:
a suture thread, and a sharp-tipped needle attached to a least one end of said suture thread, said needle having a substantially straight body co-axially aligned with said suture thread, said body including a holding portion having a different cross-sectional profile than portions of said body surrounding said holding portion.
an axially elongated support shaft, and a suturing assembly at a distal end of said support shaft, including a first suture holder supported by said support shaft for removably holding a needled suture, said first suture holder including a suture inlet through which at least part of the suture can be passed, and a second suture holder supported by said support shaft for passively capturing said needled suture, said first suture holder or said second suture holder being an actuatable member pivotably supported for movement toward and away from an operating position to passively capture said needled suture in said second suture holder as the actuatable member moves toward the operating position, and to remove the needled suture from said first suture holder when said actuatable member moves away from said operating position, said suture inlet in said first suture holder enabling complete removal of the suture from said first suture holder when said actuatable member and said needled suture move away from said operating position, said needled suture comprising:
a suture thread, and a sharp-tipped needle attached to a least one end of said suture thread, said needle having a substantially straight body co-axially aligned with said suture thread, said body including a holding portion having a different cross-sectional profile than portions of said body surrounding said holding portion.
18. A suture anchor assembly, comprising:
an anchor for attachment to bone, at least one needled suture for use with said anchor, said needled suture, comprising:
a suture thread, and a substantially straight, sharp tipped needle attached to a least one end of said suture thread, said needle including a holding portion having a different cross-sectional profile than portions of said needle surrounding said holding portion.
an anchor for attachment to bone, at least one needled suture for use with said anchor, said needled suture, comprising:
a suture thread, and a substantially straight, sharp tipped needle attached to a least one end of said suture thread, said needle including a holding portion having a different cross-sectional profile than portions of said needle surrounding said holding portion.
19. The suture anchor assembly of claim 18 wherein said suture thread has said needle attached to each end of said suture thread.
20. A method of suturing comprising the steps of:
punching a distal end of a needle of a needled suture through tissue to be sutured at a suture site thus creating a hole through the tissue through which a suture thread of said needled suture can pass, actuating an actuatable member to grab said distal end of said needle in a passive spring fit, moving said actuatable member away from the tissue being sutured to pull said suture thread through said suture hole without engaging a distal end of said suture thread, and removing only a needled end of said needled suture from said suture site by withdrawing said actuating member.
punching a distal end of a needle of a needled suture through tissue to be sutured at a suture site thus creating a hole through the tissue through which a suture thread of said needled suture can pass, actuating an actuatable member to grab said distal end of said needle in a passive spring fit, moving said actuatable member away from the tissue being sutured to pull said suture thread through said suture hole without engaging a distal end of said suture thread, and removing only a needled end of said needled suture from said suture site by withdrawing said actuating member.
21. The method of claim 20 wherein said punching is facilitated by actuation of said actuatable member pivoting toward its operating position.
22. The method of claim 20 wherein said needle is held in a suture holder during punching of the distal end of said needle through the tissue, said method including removing said needle from said suture holder by the action of grabbing said distal end of said needle with said actuatable member and moving said member away from said tissue.
23. A method of minimally-invasively suturing deep tissue through a portal comprising the steps of:
anchoring a suture thread having a needle attached thereto at each end to a suture anchor, suturing a first tissue using a first of said needled ends of said suture thread, and suturing a second tissue using a second of said needled ends of said suture thread, said suture thread, during said both suturing steps, always being anchored to said suture anchor.
anchoring a suture thread having a needle attached thereto at each end to a suture anchor, suturing a first tissue using a first of said needled ends of said suture thread, and suturing a second tissue using a second of said needled ends of said suture thread, said suture thread, during said both suturing steps, always being anchored to said suture anchor.
24. A suture passing forceps, comprising:
an axially elongated support shaft, and a suturing assembly at a distal end of said support shaft, including a first suture holder supported by said support shaft for removably holding a needled suture, said suture holder including a suture inlet through which at least part of the suture can be passed, and a second suture holder supported by said support shaft for capturing said needled suture, said first suture holder or said second suture holder being an actuatable member pivotably supported for movement toward and away from an operating position to capture said needled suture in said second suture holder as the actuatable member moves toward the operating position, and to remove the needled suture from said first suture holder when said actuatable member moves away from said operating position, said second suture holder including a holding region partially defined by a contoured surface permitting the needled suture to slide within said holding region.
an axially elongated support shaft, and a suturing assembly at a distal end of said support shaft, including a first suture holder supported by said support shaft for removably holding a needled suture, said suture holder including a suture inlet through which at least part of the suture can be passed, and a second suture holder supported by said support shaft for capturing said needled suture, said first suture holder or said second suture holder being an actuatable member pivotably supported for movement toward and away from an operating position to capture said needled suture in said second suture holder as the actuatable member moves toward the operating position, and to remove the needled suture from said first suture holder when said actuatable member moves away from said operating position, said second suture holder including a holding region partially defined by a contoured surface permitting the needled suture to slide within said holding region.
25. The suture passing forceps of claim 24 wherein said second suture holder comprises said actuatable member.
26. The suture passing forceps of claim 24 wherein said contoured surface is configured to facilitate removal of said needled suture from said holding region.
27. The suture passing forceps of claim 24 wherein said second suture holder passively captures said needled suture.
28. The suture passing forceps of claim 27 wherein said holding region has a spring force for removably holding a needle of the needled suture.
29. The suture passing forceps of claim 28 wherein said holding region defines a passive spring fit.
30. The suture passing forceps of claim 29 wherein said second suture holder includes a jaw defining a slot of a selected width, said holding region being defined by an enlarged section of said slot into which the needle can be spring fit, the relative sizes of said needle and said enlarged section of said holding region defining, in part, said spring force.
31. The suture passing forceps of claim 24 wherein said suture inlet in said first suture holder enables complete removal of the suture from said first suture holder when said actuatable member and said needled suture move away from said operating position.
32. The suture passing forceps of claim 24 wherein said first suture holder includes a jaw and said suture inlet is defined by a slot of a selected width in said jaw through which a suture thread of the needled suture can pass, a needle holding region being defined by an enlarged section of said slot, a first portion of said enlarged section having a diameter greater than a diameter of the needle of the needled suture and a second portion of said enlarged section having a diameter less than the diameter of the needle.
33. The suture passing forceps of claim 32 wherein said slot is of limited depth extending from a surface of said jaw to said enlarged section.
34. A suture passing forceps for passing a needled suture, comprising:
an axially elongated support shaft, and a suturing assembly at a distal end of said support shaft, including a first suture holder supported by said support shaft for removably holding a needled suture, said suture holder including a suture inlet through which at least part of the suture can be passed, and a second suture holder supported by said support shaft for capturing said needled suture, said first suture holder or said second suture holder being an actuatable member pivotably supported for movement toward and away from an operating position to capture said needled suture in said second suture holder as the actuatable member moves toward the operating position, and to remove the needled suture from said first suture holder when said actuatable member moves away from said operating position, said second suture holder including a holding region defined by a contoured surface permitting the needled suture to slide within said holding region, said needled suture comprising:
a suture thread, and a sharp-tipped needle attached to a least one end of said suture thread, said needle having a substantially straight body co-axially aligned with said suture thread, said body including a holding portion having a different cross-sectional profile than portions of said body surrounding said holding portion.
an axially elongated support shaft, and a suturing assembly at a distal end of said support shaft, including a first suture holder supported by said support shaft for removably holding a needled suture, said suture holder including a suture inlet through which at least part of the suture can be passed, and a second suture holder supported by said support shaft for capturing said needled suture, said first suture holder or said second suture holder being an actuatable member pivotably supported for movement toward and away from an operating position to capture said needled suture in said second suture holder as the actuatable member moves toward the operating position, and to remove the needled suture from said first suture holder when said actuatable member moves away from said operating position, said second suture holder including a holding region defined by a contoured surface permitting the needled suture to slide within said holding region, said needled suture comprising:
a suture thread, and a sharp-tipped needle attached to a least one end of said suture thread, said needle having a substantially straight body co-axially aligned with said suture thread, said body including a holding portion having a different cross-sectional profile than portions of said body surrounding said holding portion.
35. A method of suturing comprising the steps of punching a distal end of a needle of a needled suture through tissue to be sutured at a suture site thus creating a hole through the tissue through which a suture thread of said needled suture can pass, grabbing said distal end of said needle within a holding region in a first suture holder, pulling said suture thread through said suture hole without engaging a distal end of said suture thread, removing only a needled end of said needled suture from said suture site, and removing said needled suture from said first suture holder by sliding said needled suture along a contoured surface of said holding region.
36. The method of claim 35 wherein said punching is facilitated by actuation of said suture holder pivoting toward an operating position.
37. The method of claim 35 wherein said needle is held in a second suture holder during punching of the distal end of said needle through the tissue, said method including removing said needle from said second suture holder by the action of grabbing said distal end of said needle with said first suture holder and moving said first suture holder away from said tissue.
38. The method of claim 35 wherein said distal end of said needle is grabbed in a passive spring fit within said holding region.
Applications Claiming Priority (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US47951495A | 1995-06-07 | 1995-06-07 | |
| US08/479,514 | 1995-06-07 | ||
| US08/603,859 US5730747A (en) | 1995-06-07 | 1996-02-22 | Suture passing forceps |
| US08/603,859 | 1996-02-22 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2220954A1 true CA2220954A1 (en) | 1996-12-19 |
Family
ID=27046265
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002220954A Abandoned CA2220954A1 (en) | 1995-06-07 | 1996-06-05 | Suture passing forceps |
Country Status (10)
| Country | Link |
|---|---|
| US (1) | US5730747A (en) |
| EP (1) | EP0836427B1 (en) |
| JP (2) | JPH11506670A (en) |
| AT (1) | ATE274838T1 (en) |
| AU (1) | AU700539B2 (en) |
| BR (1) | BR9609405A (en) |
| CA (1) | CA2220954A1 (en) |
| DE (1) | DE69633284T2 (en) |
| DK (1) | DK0836427T3 (en) |
| WO (1) | WO1996039948A1 (en) |
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- 1996-02-22 US US08/603,859 patent/US5730747A/en not_active Expired - Lifetime
- 1996-06-05 DK DK96917177T patent/DK0836427T3/en active
- 1996-06-05 WO PCT/US1996/008896 patent/WO1996039948A1/en active IP Right Grant
- 1996-06-05 CA CA002220954A patent/CA2220954A1/en not_active Abandoned
- 1996-06-05 AU AU59845/96A patent/AU700539B2/en not_active Expired
- 1996-06-05 AT AT96917177T patent/ATE274838T1/en not_active IP Right Cessation
- 1996-06-05 DE DE69633284T patent/DE69633284T2/en not_active Expired - Lifetime
- 1996-06-05 JP JP9501358A patent/JPH11506670A/en active Pending
- 1996-06-05 EP EP96917177A patent/EP0836427B1/en not_active Expired - Lifetime
- 1996-06-05 JP JP50135897A patent/JP3856472B2/en not_active Expired - Fee Related
- 1996-06-05 BR BR9609405A patent/BR9609405A/en not_active Application Discontinuation
Also Published As
| Publication number | Publication date |
|---|---|
| JPH11506670A (en) | 1999-06-15 |
| DK0836427T3 (en) | 2005-01-10 |
| EP0836427B1 (en) | 2004-09-01 |
| WO1996039948A1 (en) | 1996-12-19 |
| BR9609405A (en) | 1999-05-11 |
| US5730747A (en) | 1998-03-24 |
| JP3856472B2 (en) | 2006-12-13 |
| AU5984596A (en) | 1996-12-30 |
| AU700539B2 (en) | 1999-01-07 |
| EP0836427A4 (en) | 1999-11-24 |
| DE69633284D1 (en) | 2004-10-07 |
| DE69633284T2 (en) | 2005-09-22 |
| EP0836427A1 (en) | 1998-04-22 |
| ATE274838T1 (en) | 2004-09-15 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| FZDE | Discontinued |